Optimal Blood Pressure we Should Target? Systolic Under 110 or 100?

‘Normal’ blood pressure is no longer a safe haven: take shelter under ‘optimal’ blood pressure

Several population-based studies have demonstrated that SBP levels currently considered normal (<130 mmHg) are not safe, and in fact, there is a graded increase in CVD risk as SBP increases beyond 90 mmHg.4–7 Whelton et al .6 found that the amount of coronary artery calcium and the risk of incident atherosclerotic CVD increase with increasing SBP levels, even in individuals with SBP 90–120 mmHg. In fact, mounting evidence has made it abundantly clear that so-called high normal BP levels (120–129 mmHg) are associated with a significant increase in incident CVD compared with SBP levels of 90–100 mmHg. This connection may be much more pronounced in yet to be identified subgroups. This means that CVD risk starts even when SBP is a long way below 130/80 mmHg, which is the current threshold used to diagnose and define hypertension.8 Therefore, the guideline-based definition of normal BP does not provide freedom from CVD risk. Without a doubt, SBP of 120–130 mmHg is a harbinger of significant chronic disease burden and portends a poor prognosis. Overall, CVD risk appears to be independently associated with SBP levels, starting at 90 mmHg.

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Full Paper:

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Bill Faloon, owner of Life Extension, mentioned earlier this year that he targets below 90 SBP. He takes Telmisartan in order to lower his SBP. I take a small dose of Telmisartan and my SBP is below 110 but I have been wary of lowering my SBP any further.

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Have you seen this section on HBP?

As long as you’re not getting side effects (fainting etc), it seems like a good idea, as it might lower BP during activities as well (and thus entire day BP)?

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What is the dose he is taking?

SBP below 90 is definitely too low and difficult to tolerate for older people with prior history of hypertension or cardiovascular disease. They may develop positional dizziness and even possible syncopal episodes/loss of consciousness. Cardiologists push SBP not higher than 110.

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What’s your telmisartan dose? Mine is 20mg, and my systolic BP is between 120 and 130. In addition to telmisartan, I also take 50mg/twice/day Labetalol.

He didn’t say - he did say that Telmisartan is quite safe. He made these comments during on of his online presentations about 2 months ago.

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I am also taking 20mg Telmisartan. That was the lowest dose that my favorite pharmacy had.

LIfe Extension article on Telmisartan can be found at:

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I am 72 so I fit your older people criteria I suppose. I don’t have cardiovascular disease (unless you consider bradycardia-sick sinuss node- as a cardiovascular disease). I have a pacemaker but I doubt I could tolerate a 90 SBP. I have had a few incidents of passing out while walking quickly in tropical climates in Kuala Lumpur and Bangkok. I come to before I hit the ground - but damage still could be done. My resting SBP with 20 mg Telmisartan is only 5 points or so lower than without.

In 2017 Dr. Blagosklonny wrote a paper titled “From rapalogs to anti-aging formula”. In the paper he wrote about angiotensin II inhibitors like Telmisartan. He found research that indicated some positive results in animals and humans who take these inhibitors - even for those who have normal BP.
This is a paragraph from his paper:

Inhibitors of angiotensin II
Angiotensin II receptor blockers (ARB) such
as Valsartan, Telmisartan, Losartan and angiotensinconverting
enzyme (ACE) inhibitors such as Captopril,
Lisinopril, Enalapril, Ramipril are widely used to treat
hypertension. Hypertension is a clear-cut disease of
hyperfunction. Angiotensin II, a hormone, is involved in
age-related diseases in mammals [167, 168]. Disruption
of the angiotensin II receptor increases longevity in mice
[169]. Variations of the angiotensin II receptor gene are
associated with longevity in humans [170]. Inhibitors of
angiotensin II double lifespan of hypertensive rats [171,
172]. This dramatic (100%) increase is in part due to the
anti-hypertensive effect. Yet, in healthy (those with normal
blood pressure) rats, long-term treatment with enalapril
decreases weight and prolongs life span dramatically
[173]. In humans, inhibitors of angiotensin II prevent
cardiac hypertrophy and organ fibrosis [168], [174], a
hallmark of aging. In some studies, long-term use of ARBs
was associated with a lower incidence of cancer [175].
Enalapril and perindopril did not decrease blood pressure
in patients with normal blood pressure [176]. Importantly,
angiotensin-converting enzyme inhibitors or angiotensin
receptor blockers are beneficial in normotensive
atherosclerotic patients [177].

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Bryan Johnson blood pressure:
image

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don’t take any bp medications but bp is 100/68
never changed my entire life now 70

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Anyone have any negative side effects with taking Telmisartan? Also, can you recommend a good blood pressure device that is accurate but does not break the bank?

I was wondering is there any natural way to keep your BP low? Or maybe supplements that work? My BP is usually around 110-120 and I would ideally want it to be a bit lower but I don’t want to commit to another prescription medicine at this moment.

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I have been controlling my B/P for over 7 yrs now. I log my weight and B/P every morning. Currently 76 yo., I take Lisinopril 5 mg daily in morning. At night, 8 mg. Doxazosin for BPH, but has an affect on B/P, along with Candesartan 8 mg. Have found that the combination of different B/P drugs works best for me at the lowest dose. This morning my B/P was 94/54 which is lower than my goal so I skipped the Lisinopril this morning. Have to adjust down dosing when I lose 2-3 lbs. But may lower my goal after this paper. My heart rate as measured by fitness tracker at night goes all the way down to 41, but mostly around 45-49. Am a firm believer in very low B/P for longevity benefits. Am careful about too low. Do not want to faint especially in public.

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Do not know what your definition of “break the bank” is.

Look at units that are made by a real manufacture such as OMRON, their are other’s

I avoid branded units{any equipment] made by another company, such as RiteAid, they sell there brand but they are not the manufacturer of the unit.

The most accurate is a real mercury unit, {you need a person to assist in using, as you require a stethoscope to hear as you view the numbers) not convenient.

Any self contained electronic unt is + or - 3% as 3% is the “acceptable” deviation requires for “FDA” marketing approval.

There was a thread in more detail on this forum.

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According to Peter Attia it’s possible to learn to do this oneself, although he recommends an automatic one for starters.

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Yes it is, most will not.

FWIW

I have several pieces of equipment that measure BP

From a mercury sphygmomanometer to many(more than required) in an electrical version

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I’ve been on Amlodipine and Olmesartan at seperate times over the last year and havent seen a reduction in BP. I also take a stimulant for ADHD and an SSRI for anxiety both of those slightly raise my BP. My psychiatrist calls it a trade-off and not to worry so much, but hes not focused on my longevity of course.

Anyone have other suggestions?

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The following have lowered my blood pressure:

  • eat less sodium/eat more potassium
  • supplements: magnesium, quercetin, fisetin, lactoferrin, citrulline
  • foods: beets, ground flaxseed, nuts/seeds, chicken, and salmon (chicken has peptides that lower blood pressure)
  • herbal teas: mint tea (and maybe hibiscus tea, chamomile tea)
  • cardio exercise
  • reduce stress
  • sauna
  • don’t eat too much
  • spend time with family and friends
  • watch comedies

I have a machine at home and I measure my BP every night. I then write down anything special that I’ve eaten or done that day. Over time, I started to see patterns of things that lower my BP and things that raise my BP. So the list above came from that process.

By far the thing that raises my BP the most is stress. Sodium intake is second. Interestingly, calcium from dairy also raises my BP. I guess calcium allows muscles to contract and therefore increases BP. Coffee (likely due to caffeine) raises my BP so I don’t drink coffee; I drink water, green tea, and herbal teas.

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